Temporäre Endgelenkstransfixation bei subkutanen Strecksehnenabrissen der Zone 1 am Fingerendglied

2021 ◽  
Vol 53 (05) ◽  
pp. 441-446
Author(s):  
Nadine Suffa ◽  
Pauline Merkel ◽  
Raymund E. Horch ◽  
Andreas Arkudas ◽  
Ingo Ludolph ◽  
...  
Keyword(s):  
Postoperative Komplikationen ◽  
Dash Score ◽  
Quick Dash

Zusammenfassung Ziel Diese retrospektive, unizentrische Kohortenstudie untersucht die klinischen und subjektiven Ergebnisse nach temporärer K-Drahttransfixation in leichter Überstreckung des distalen Interphalangealgelenkes bei Strecksehnenabrissen. Patienten und Methoden Die demografischen Daten der Patienten, der Bewegungsumfang des Endgelenkes, der Quick-DASH-Score sowie die Patientenzufriedenheit (0 = unzufrieden, 10 = sehr zufrieden), fortbestehende Schmerzen (ja/nein) und postoperative Komplikationen wurden anhand eines eigens entworfenen Fragebogens und einer zur Bestimmung des Bewegungsausmaßes des Fingerendgelenkes durch die Patienten selbst entwickelten Schablone ermittelt. Fragebogen und Schablone wurden 132 Patienten zugesandt, bei denen im Zeitraum von Januar 2009 bis Dezember 2019 ein Strecksehnenabriss am Fingerendgelenk mittels temporärer K-Drahttransfixation behandelt wurde. 65 Patienten (49,2 %) – 40 Männer und 25 Frauen mit einem durchschnittlichen Alter von 53,3 Jahren – sandten Fragebogen und Schablone vollständig ausgefüllt zurück. 40-mal lag eine akute, 25-mal eine chronische Verletzung vor. 35-mal (54 %) war der Mittel-, 19-mal (29 %) der Klein-, 10-mal (15 %) der Ring- und nur einmal (2 %) der Zeigefinger betroffen. Das Gesamtergebnis wurde unter Berücksichtigung des Streckdefizits entsprechend der Crawford-Klassifikation und dem Vorhandensein von persistierenden Schmerzen bewertet. Ergebnisse Entsprechend der modifizierten Crawford-Klassifikation fanden sich 75 % exzellente, 14 % gute und 11 % befriedigende Ergebnisse. Die Patienten waren subjektiv im Durchschnitt mit 7,9 von 10 Punkten sehr zufrieden. 15 Patienten berichteten über Komplikationen, 6 davon beklagten anhaltend Schmerzen. Der Quick-DASH-Score lag durchschnittlich bei 5,4 Punkten. Schlussfolgerung Die temporäre Transfixation des distalen Interphalangealgelenkes in Hyperextensionsstellung stellt ein effektives Verfahren zur Behandlung subkutaner Strecksehnenabrisse mit hoher Patientenzufriedenheit dar.

A proximal interphalangeal joint custom-made orthosis in trigger finger: Functional outcome

Hand Therapy ◽  
2021 ◽  
pp. 175899832110187
Author(s):  
Kawee Pataradool ◽  
Chayanin Lertmahandpueti
Keyword(s):  
Outcome Measures ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Mean Difference ◽  
Trigger Finger ◽  
Symptom Improvement ◽  
Dash Score ◽  
Full Time ◽  
Custom Made ◽  
Quick Dash

Introduction Trigger finger is a common and functionally limiting disorder. Finger immobilization using an orthotic device is one of the conservative treatment options for treating this condition. The most common orthosis previously described for trigger finger is metacarpophalangeal joint immobilization. There are limited studies describing the effectiveness of proximal interphalangeal joint orthosis for treatment of trigger finger. Methods This study was a single group pretest-posttest design. Adult patients with single digit idiopathic trigger finger were recruited and asked to wear a full-time orthoses for 6 weeks. The pre- and post-outcome measures included Quick-DASH score, the Stages of Stenosing Tenosynovitis (SST), the Visual Analogue Scale (VAS) for pain, the number of triggering events in ten active fists, and participant satisfaction with symptom improvement. Orthotic devices were made with thermoplastic material fabricated with adjustable Velcro tape at dorsal side. All participants were given written handouts on this disease, orthotic care and gliding exercises. Paired t-tests were used to determine changes in outcome measures before and after wearing the orthosis. Results There were 30 participants included in this study. Evaluation after the use of PIP joint orthosis at 6 weeks revealed that there were statistically significant improvements in Quick-DASH score from enrolment (mean difference −29.0 (95%CI −34.5 to −23.4); p < 0.001), SST (mean difference −1.4 (95%CI −1.8 to −1.0); p < 0.001) and VAS (mean difference −3.4 (95%CI −4.3 to −2.5); p < 0.001). There were no serious adverse events and patient satisfaction with the treatment was high. Conclusions Despite our small study size, the use of proximal interphalangeal joint orthosis for 6 weeks resulted in statistically significant improvements in function, pain and triggering, and also high rates of acceptance in patients with isolated idiopathic trigger finger.

scholarly journals A study on the outcome of displaced midshaft non-comminuted clavicle fractures treated with anatomical locking plate versus titanium elastic nail

2020 ◽  
pp. 221049172097518
Author(s):  
Vineet Thomas Abraham ◽  
Chandrasekaran Marimuthu
Keyword(s):  
Functional Outcome ◽  
Locking Plate ◽  
Plate Versus ◽  
Dash Score ◽  
Titanium Elastic Nail ◽  
Constant Murley Score ◽  
Elastic Nail ◽  
Clavicle Fractures ◽  
The Mean ◽  
Quick Dash

Purpose: Fixation of displaced midshaft clavicle is well known to decrease nonunion, malunion and shoulder disability as compared to nonoperative treatment. This study was done to compare the clinical and functional outcome of group 1 clavicle fractures treated with anatomic locking plates (ALP) versus Titanium elastic nail (TEN). Methods: We studied patients presenting with displaced midshaft clavicle fractures treated with ALP or TEN. The study period was from Jan 2013 to Dec 2016. Patients were reviewed and at each visit clinical and radiological progress of union was noted, complications if any were noted, functional assessment was done using the quick Dash score and Constant Murley score. Results: A total of 116 patients met our inclusion criteria. 62 patients were treated with TEN and 54 with ALP. Bony union was achieved at an average of 11.8 weeks in the TENS group and 12.8 weeks in the ALP group post operatively and this was found to be significant. The mean postoperative Constant Murley score in the ALP and the TEN groups were 92.8 (range 80–97), and 93.7 (82–97) respectively. The mean postoperative quick dash score in the ALP and TEN groups were 2.48(range from 0 to 6.8) and 2.1 (range 0–9.1) respectively. Conclusion: Both Anatomical locking plate and TEN are good options for the treatment of non-comminuted mid clavicular fractures as they have a similar functional outcome. TEN nail insertion has the advantage of being minimally invasive, having a faster union time and may be recommended in midshaft clavicle fractures without comminution.

Perkutane, antegrade K-Draht-Osteosynthese bei Fingergrundgliedfrakturen: Vergleich zwischen frühfunktioneller und statischer Nachbehandlung

2021 ◽  
Vol 53 (05) ◽  
pp. 467-474
Author(s):  
Ines Ana Ederer ◽  
Johannes von Fraunberg ◽  
Jonas Kolbenschlag ◽  
Andreas Nusche ◽  
Adrien Daigeler ◽  
...  
Keyword(s):  
Postoperative Komplikationen ◽  
Retrospektive Studie ◽  
Dash Score ◽  
Active Motion ◽  
Fand Sich ◽  
Passive Motion ◽  
Total Active Motion

Zusammenfassung Ziel Diese retrospektive Studie vergleicht die klinischen Ergebnisse der frühfunktionellen Nachbehandlung mit den Ergebnissen mittels 6-wöchiger Schienenruhigstellung nachbehandelter Fingergrundgliedfrakturen nach perkutaner, antegrader K-Draht-Osteosynthese. Patienten und Methoden Von insgesamt 90 Patienten, die zwischen 2010 und 2017 aufgrund einer isolierten Fingergrundgliedfraktur nach geschlossener Reposition mittels perkutaner, antegrader K-Draht-Osteosynthese operativ versorgt wurden, konnten 46 (17 Frauen und 29 Männer mit einem mittleren Alter von 42,8 Jahren) im Mittel nach 18,5 Monaten nachuntersucht werden. Bei 28 Patienten war eine frühfunktionelle, bei 18 eine statische Nachbehandlung erfolgt. Beide Gruppen unterschieden sich nicht statistisch signifikant bzgl. des Alters, der Geschlechtsverteilung, der Frakturlokalisation und -morphologie, des Unfallmechanismus und der Dauer der Operation. Bei der Nachuntersuchung wurde die aktive und passive Beweglichkeit des operierten Fingers (total active motion [TAM] und total passive motion [TPM], Fingerkuppen-Hohlhand-Abstand [FKHA], Nagelrand-verlängerter-Handrückenebenen-Abstand [NHREA]) und des korrespondierenden, unverletzten Fingers der Gegenseite gemessen und in Relation zueinander gesetzt (TAMrel, TPMrel). Des Weiteren wurde die Kraft bei verschiedenen Griffformen bestimmt und in Relation zur Kraft der unverletzten Gegenseite gesetzt. Intra- und postoperative Komplikationen, der DASH-Score und die Zeit bis zur Wiederaufnahme der Arbeitstätigkeit wurden erfasst. Ergebnisse Keine signifikanten Unterschiede zwischen den beiden Gruppen konnten bzgl. der Häufigkeit von Komplikationen und notwendiger Revisionen, der Fingerbeweglichkeit und Kraft festgestellt werden. Patienten mit aktiver Nachbehandlung kehrten im Vergleich zu Patienten mit statischer Nachbehandlung jedoch signifikant früher an ihre Arbeitsplätze zurück (2,5 vs. 9,0 Wochen nach operativer Versorgung, p = 0,035). Der DASH-Score in der Gruppe mit aktiver Nachbehandlung war mit 1,7 Punkten etwas niedriger als in der Gruppe mit statischer Nachbehandlung mit 2,5 Punkten (p = 0,269). Schlussfolgerung Patienten mit frühfunktioneller Nachbehandlung waren signifikant kürzer arbeitsunfähig. Zum Nachuntersuchungszeitpunkt fand sich kein Unterschied in der globalen Fingerbeweglichkeit beider Gruppen. Bei gegebener Compliance kann auf eine postoperative Ruhigstellung verzichtet werden.

Distal interphalangeal Joint Arthrodesis using only Kirschner Wires in small distal Phalanges

2021 ◽  
Vol 53 (05) ◽  
pp. 462-466
Author(s):  
Jun-Ku Lee ◽  
Soonchul Lee ◽  
SeongJu Choi ◽  
Dong Hun Han ◽  
Jongbeom Oh ◽  
...  
Keyword(s):  
Distal Phalanx ◽  
Bony Union ◽  
Dash Score ◽  
Medical Database ◽  
X Ray ◽  
Wire Fixation ◽  
Distal Interphalangeal ◽  
K Wires ◽  
Quick Dash

Abstract Purpose To report the clinical and radiographic results of arthrodesis of relatively small-sized distal interphalangeal joints (DIPJs) using only K-wire fixation. Patients and methods Between January 2000 and December 2018 28 arthrodesis in 21 patients (9 males and 12 females with an average age of 52.1 years) with relatively small-sized DIPJs were performed using only K-wires. Data on patient’s characteristics, such as age, sex, affected finger, and the number and size of the used k-wires were collected from the medical database. The narrowest diameter of the cortex and medulla of the distal phalanx was measured on preoperative plain radiographs. The time to union and the arthrodesis angle was determined using serial X-ray radiography follow-up. Preoperatively and at the latest follow-up examination, pain using the visual analogue scale (VAS) and the quick DASH score was registered. In addition, complications were investigated. Results Average follow-up period was 11.4 months. The small finger was mostly affected (n = 12; 42.9 %). The narrowest diameters of the distal phalanx cortex and the medulla measured on preoperative X-ray images were 2.8 mm (SD 0.5) and 1.2 mm (SD 0.4), respectively. Seven fusions were done with use of 1 K-wire, 20 with 2 (71.4 %), and 1 with 3 K-wires. The most common K-wire sizes were 1.1-inch (24 K-wires = 48 %), and 0.9 inch (21 K-wires = 42 %) The preoperative VAS score and quick DASH score improved from 6.1 (range: 0–9) and 25.8 (range: 2–38) to 0.4 (range: 0–2) and 3.4 (range: 0–10.2), respectively. 25 (89.3 %) out of 28 fingers achieved bony union in an average of 96.1 days (range: 58–114) with three non-union. Conclusion Arthrodesis of small DIPJs with K-wire fixation has a high success rate. Therefore, we suggest K-wire fixation as an acceptable alternative for patients with a small phalanx which may be at risk of mismatch with bigger implants. However, concerns remain in terms of fusion delay with K-wire only fixation.

scholarly journals STUDY OF UPPER LIMB PERIPHERAL NERVE PATHOLOGIES WITH SPECIAL EMPHASIS ON QUICK DASH SCORE AND SELECTED ELECTROMYOGRAPHIC PARAMETERS

2018 ◽  
Vol 7 (04) ◽  
pp. 499-503
Author(s):  
Archana Verma ◽  
Sachin Verma ◽  
Sonia Moses ◽  
Rajkumar Mathur ◽  
Lukesh Patil ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Upper Limb ◽  
Dash Score ◽  
Quick Dash

Is Subacromial Balloon Spacer Appropriate for Treatment of Irreparable Rotator Cuff Tears in Elderly Patients?

2019 ◽  
Vol 21 (6) ◽  
pp. 417-426
Author(s):  
Kamil Yamak ◽  
Hüseyin Gökhan Karahan ◽  
Taşkın Altay ◽  
Cemil Kayalı ◽  
Fırat Ozan
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Dash Score ◽  
X Rays ◽  
Preoperative Period ◽  
Subacromial Space ◽  
Significant Difference ◽  
The Difference ◽  
Quick Dash

Background. The aim of this study was to evaluate the clinical and radiographic results of surgical treatment of irreparable rotator cuff tears by subacromial balloon spacer insertion in patients over 65 years old. Material and methods. Results of patients with failed conservative treatment for irreparable rotator cuff tears and who underwent subacromial balloon spacer insertion were evaluated retrospectively. The VAS and Quick-DASH scores were used for clinical and functional assessment. Results. Eleven patients were included. Mean age of patients was 69.1 (range: 65-77) years old. Evaluation of anteroposterior shoulder x-rays revealed Hamada grade 2 and grade 1 arthropathy in 10 patients (91%) and 1 patient (9%),respectively. Mean duration of follow-up was 45.09 (±5.43,37-52) months. The difference in the subacromial space measured from standard AP shoulder x-rays in the preoperative period, in the 6th postoperative month, and at the end of follow-up was 5.44 mm (2.29), 6.51 mm (±2.23), and 5.08 mm (±2.13), respectively. Mean Quick-DASH score was 74.49(±14.36) in the preoperative period, compared to 72.19 (±14.38) at the end of follow-up. There was no statistically significant difference between preoperative period and end of follow-up scores in terms of mean Quick-DASH scores (p= 0.232). Mean VAS score was 7.09 (±0.831) in the preoperative period and 6.64 (±0.809) at the end of follow-up. No statistically significant difference was revealed in terms of mean VAS scores when preoperative and end of follow-up scores were compared (p=0.333). Conclusion. Clinical and radiographic results of subacromial balloon spacer insertion in the treatment of irreparable rotator cuff tears could not be evaluated as satisfactory.

scholarly journals Intercalary Tricortical Iliac Bone Graft in the Surgical Treatment of Nonunion of Midshaft Clavicular Fractures

2012 ◽  
Vol 15 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Chul Hyun Cho ◽  
Hyung Gyu Jang
Keyword(s):  
Bone Graft ◽  
Clinical Outcomes ◽  
Plate Fixation ◽  
Arthroscopic Surgery ◽  
Iliac Bone ◽  
Dash Score ◽  
Structural Support ◽  
Iliac Bone Graft ◽  
Quick Dash

PURPOSE: The purpose of this study was to evaluate the radiologic and clinical outcomes after intercalary tricortical iliac bone graft with plate fixation for the nonunion of midshaft clavicular fractures.MATERIALS AND METHODS: Between September 2007 and May 2011, 10 patients who were treated by the intercalary tricortical iliac bone graft, with plate fixation for clavicle nonunion, were studied. The mean follow-up period was 30.7 (12~57) months. After the sclerotic bone was excised to the bleeding cortical bone, we interposed the tricortical iliac bone to provide structural support and restore clavicle length, and then fixed the plate and screws. The radiologic outcomes on the serial plain radiographs and clinical outcomes, according to UCLA, ASES and Quick DASH scores, were analyzed.RESULTS: Bony union was obtained in all cases (100%) and the average union time was 18.4 (14~24) weeks. The average respective UCLA and ASES scores improved from 16.7 and 52.1 preoperatively to 27.4 and 83.6 postoperatively (p<0.05). The average Quick DASH score was 40.5, at the final follow-up. Complications were 2 shoulder stiffness, and one case had removal of device and arthroscopic surgery at 11 months, postoperatively. There were no implant failure or infection.CONCLUSION: Intercalary tricortical iliac bone graft, with plate fixation for the nonunion of midshaft clavicular fractures, is a good option that can provide structural support and restore clavicle length, as well as high union rate.

scholarly journals Arthroscopic Bankart Repair vs. Open Latarjet Procedure: A Comparative Study of Clinical and Functional Results.

2020 ◽  
Author(s):  
Binod Sherchan ◽  
Saroj Rai ◽  
Nira Tamang ◽  
Siddhartha Dhungana ◽  
Laxmi Kanta Sharma ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
External Rotation ◽  
Operating Cost ◽  
Bankart Repair ◽  
Dash Score ◽  
Latarjet Procedure ◽  
Arthroscopic Bankart Repair ◽  
Significant Difference ◽  
Quick Dash

Abstract Background The primary aim of this study was to compare the clinical outcomes of patients undergoing arthroscopic Bankart repair and open Latarjet procedure for recurrent dislocation of the shoulder. Secondary aims were to assess and compare the cost-effectiveness, satisfaction and complications, including recurrence and infection. Methods We retrospectively evaluated the patients who underwent either arthroscopic Bankart repair with or without Remplissage procedure or open Latarjet procedure between May 2015 and May 2018. The preoperative data were collected from the hospital records, and the postoperative data were collected during the follow-up visit. At the final follow-up, 41(male=32, female=9) patients in the Bankart group and 40(male=34 and female=6) patients in the Latarjet group were included in the study. Clinical outcomes were assessed using the ASES score, Rowe score, and Quick DASH score. A self-constructed scale that consisted of satisfied and dissatisfied was used to measure the level of satisfaction. Any complications were recorded in every follow-up visit. Collected data were analyzed using SPSS version 25. Results There was no statistically significant difference regarding the age (p=0.401), gender (p=0.569), site of involvement (p=0.158), number of preoperative dislocations (p=0.085), follow-up (p=0.061), between the two groups. Similarly, no statistically significant difference existed regarding the ASES score (p=0.388), Rowe score (p=0.211), and Quick DASH score (p=0.713). The average external rotation was 83 degrees in the Bankart group and 85 degrees in the Latarjet group (p=0.140). Functional satisfaction was higher in the Laterjet group compared to the Bankart group (p=0.482). Hundred percent of the patients were cosmetically satisfied in the Bankart group, whereas only 32(80%) patients were cosmetically satisfied in the Latarjet group (p=0.002). There was a significantly higher operating cost for arthroscopic Bankart repair compared to open Latarjet procedure (p<0.001). Three patients had a recurrence in the Bankart group, whereas no recurrence occurred in the Latarjet group. And, 2 superficial infections occurred in the Latarjet group. Conclusion These results provide the fact that arthroscopic Bankart repair might be a fancy and minimally invasive procedure, Latarjet procedure should still be a priority in a developing country like Nepal, where financial cost is a huge burden.

scholarly journals Short- to mid-term outcomes of radial head replacement for complex radial head fractures

2020 ◽  
Vol 23 (4) ◽  
pp. 183-189
Author(s):  
Chung-Sin Baek ◽  
Beom-Soo Kim ◽  
Du-Han Kim ◽  
Chul-Hyun Cho
Keyword(s):  
Heterotopic Ossification ◽  
Radial Head ◽  
Elbow Joint ◽  
Ulnar Neuropathy ◽  
Dash Score ◽  
Radial Head Fractures ◽  
Radial Head Replacement ◽  
The Mean ◽  
Quick Dash

Background: The purpose of the current study was to investigate short- to mid-term outcomes and complications following radial head replacement (RHR) for complex radial head fractures and to identify factors associated with clinical outcomes.Methods: Twenty-four patients with complex radial head fractures were treated by RHR. The mean age of the patients was 49.8 years (range, 19–73 years). Clinical and radiographic outcomes were evaluated for a mean follow-up period of 58.9 months (range, 27–163 months) using the visual analog scale (VAS) score for pain, the Mayo elbow performance score (MEPS), the quick disabilities of the arm, shoulder and hand (Quick-DASH) score, and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, the mean VAS score, MEPS, and Quick-DASH score were 0.6±1.1, 88.7±11.5, and 19.4±7.8, respectively. The mean range of motion was 132.7o of flexion, 4.7o of extension, 76.2o of pronation, and 77.5o of supination. Periprosthetic lucency was observed in six patients (25%). Heterotopic ossification was observed in four patients (16.7%). Arthritic change of the elbow joint developed in seven patients (29.2%). Capitellar wear was found in five patients (20.8%). Arthritic change of the elbow joint was significantly correlated with MEPS (P=0.047). Four cases of complications (16.6%) were observed, including two cases of major complications (one stiffness with heterotopic ossification and progressive ulnar neuropathy and one stiffness) and two cases of minor complications (two transient ulnar neuropathy).Conclusions: RHR for the treatment of complex radial head fractures yielded satisfactory short- to mid-term clinical outcomes, though radiographic complications were relatively high.

scholarly journals Treatment of subacute/chronic ECU tendinopathy using wrist arthroscopy and open surgical repair

2022 ◽  
Vol 30 (1) ◽  
pp. 230949902110670
Author(s):  
Young-Keun Lee
Keyword(s):  
Surgical Repair ◽  
Clinical Findings ◽  
Wrist Arthroscopy ◽  
Dash Score ◽  
Open Surgical Repair ◽  
Mri Findings ◽  
Open Procedure ◽  
Mayo Wrist Score ◽  
Quick Dash

Purpose To report the arthroscopic and clinical findings of patients with extensor carpi ulnaris (ECU) tendinopathy treated with wrist arthroscopy and open surgical repair. Methods We retrospectively reviewed the medical records of seven patients with chronic ECU tendinopathy who were treated with diagnostic wrist arthroscopy and open surgical repair between 2010 and 2017. Seven cases diagnosed with ECU tendinopathy had undergone open procedure for the ECU tendinopathy, as well as wrist arthroscopy in the same session. Any pathology of the triangular fibrocartilage complex (TFCC) diagnosed by wrist arthroscopy were treated simultaneously with open procedure for the ECU tendinopathy. The functional outcome was evaluated by comparing the preoperative and final follow-up values of range of motion (ROM), grip strength, visual analog scale (VAS) for pain, modified Mayo wrist score and quick disabilities of the arm, shoulder, and hand (DASH) score. Results TFCC tears were identified in four patients of which repair was performed concomitantly. The average follow-up period was 39 months (range, 25–49 months). At the final follow-up, all the outcomes including average VAS score (6.4→1), the ROM (173→192°), quick DASH score (42.5→18.2), and modified Mayo wrist score (48.6→79.3) improved significantly. Conclusion When treating patients with ECU tendinopathy, the possibility of TFCC combined injury should always be considered. If surgical treatment is planned, we suggest a wrist arthroscopy for more accurate diagnosis an intra-articular pathology, particularly for patients whose MRI findings suggest a degenerative tear or degeneration at the periphery of the TFCC. Additionally, if ECU and DRUJ stability is obtained by repair or reconstruction of the concurrent pathologies in the ECU subsheath, TFCC and other intra-articular structures, the results will be favorable.

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